Elsevier

NeuroImage: Clinical

Volume 17, 2018, Pages 153-162
NeuroImage: Clinical

How changes in brain activity and connectivity are associated with motor performance in people with MS

https://doi.org/10.1016/j.nicl.2017.09.019Get rights and content
Under a Creative Commons license
open access

Highlights

  • The link between brain activity, connectivity, and motor performance in MS is poorly understood.

  • Current evidence for adaptive and maladaptive brain changes is discussed.

  • We discuss a possible mechanism for maladaptive increases in ipsilateral brain activity.

Abstract

People with multiple sclerosis (MS) exhibit pronounced changes in brain structure, activity, and connectivity. While considerable work has begun to elucidate how these neural changes contribute to behavior, the heterogeneity of symptoms and diagnoses makes interpretation of findings and application to clinical practice challenging. In particular, whether MS related changes in brain activity or brain connectivity protect against or contribute to worsening motor symptoms is unclear. With the recent emergence of neuromodulatory techniques that can alter neural activity in specific brain regions, it is critical to establish whether localized brain activation patterns are contributing to (i.e. maladaptive) or protecting against (i.e. adaptive) progression of motor symptoms. In this manuscript, we consolidate recent findings regarding changes in supraspinal structure and activity in people with MS and how these changes may contribute to motor performance. Furthermore, we discuss a hypothesis suggesting that increased neural activity during movement may be either adaptive or maladaptive depending on where in the brain this increase is observed. Specifically, we outline preliminary evidence suggesting sensorimotor cortex activity in the ipsilateral cortices may be maladaptive in people with MS. We also discuss future work that could supply data to support or refute this hypothesis, thus improving our understanding of this important topic.

Keywords

Multiple sclerosis
fMRI
Motor performance
Compensation
Pathology
Transcallosal inhibition

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